Mastering the CST Portfolio and Application: A Comprehensive Guide for 2024

Applying for a CST training number in the UK is a pivotal step in a doctor’s career. With the competition being intense, it’s crucial to have a well-prepared strategy. MediGuru has meticulously compiled insights, strategies, and valuable tips from high-achieving, successful applicants to enhance the prospects of those aspiring to secure CST training number. Our expertise, drawn from aiding hundreds of candidates in achieving their CST goal, is encapsulated in our comprehensive guide, designed to assist you in crafting an impressive and effective application.

This blog post, enriched with tips and guidance from our successful course MediGuru, aims to enhance your chances of success in the CST interview and application process.

How do I apply for a Core Surgical Training (CST) number?

Applying for a Core Surgical Training (CST) number involves a multi-step process. Firstly, ensure that you meet the eligibility criteria set by the NHS. This includes having a GMC registration and requisite training or experience. Applications are typically submitted through the Oriel system, where you need to provide detailed information about your qualifications, experience, and motivations for pursuing a career in ENT. These will include achievements during medical school and foundation training.

What is the CST recruitment timeline in 2024?

The recruitment timeline for CST recruitment starts with the opening of applications in October. Shortlisting and interview invitations follow in the subsequent months, with interviews usually conducted in February. Final offers are typically released in March-April, giving candidates ample time to prepare for their new roles.

For the 2024 interview cycle, the key dates you need to be aware of are:

Applications open26th October 2023
Applications close23rd November 2023
MSRA invitations19th December 2023
MSRA window4th-16th January 2024
Upload of self-assessment documents8th-14th February 2024
MSRA results and invitations to interview8th February 2024
Interview dates19th-28th February 2024
Preferencing13th February – 5th March
Initial offers26th March 2024
Hold deadline26th March 2024
Upgrade deadline9th April 2024

What is the competition ratio for a Core Surgical Training (CST) number?

The competition ratio for CST has increased in the last few years. In 2023 there were 2539 applications for 609 posts, giving a competition ratio of 4.17. This has increased from around 2.5 in 2016/17 indicating that securing a CST number requires an even more dedicated and focused approach. This underscores the importance of thorough preparation and standout performance in every selection stage.

How is the portfolio scored for CST numbers in 2024?

The Portfolio Self-Assessment score makes up 30% of your final score and is no longer used for shortlisting.

Your portfolio/self assessment will be required to be uploaded in advance and will be validated via the evidence upload portal for each declaration of achievement made in the application. This must be uploaded during the upload window 8th February to 14th February 2024, otherwise applicants will be scored zero. Each achievement can only be used to score points in one section in the self-assessment.

It is important to complete your self-assessment honestly and accurately at the time of application, as it will not be possible to change the self-assessment score once submitted. If the verifiers feel that there is insufficient evidence for the number of points claimed in the self-assessment or the scoring differs significantly to their assessment, the score in that section will be adjusted and applicants should be expected to be contacted as part of the probity process. Appeals must be made within 72 hours of scores being released and those made after the deadline will not be considered.

How to maximise your CST portfolio points

If you are aiming to go “straight through” after Foundation Training then the earlier you start planning the more time you will have to put together a high-scoring portfolio of achievements. Start by familiarising yourself with the Person Specification, the CST Self-Assessment Scoring and the CST Applicant Handbook.

The 2024 Self Assessment scoring mark scheme and checklist contains 5 sections.

  • Commitment to specialty  (all surgical specialities) (max 10 + 4 points)
  • Quality Improvement/Clinical Audit (max 8 + 5 points)
  • Presentations and publications (max 10 points)
  • Teaching Experience (max 10 points)
  • Training Qualifications (max 5 points)

MediGuru’s tops tips for maximising your CST portfolio points

  • Start early!
  • Ask a few trusted people to look at it, we suggest a consultant, a recently successful candidate, and a lay person
  • Organise it so it is easy to find evidence and evidence is clear
  • Attention to detail is crucial
  • Keep it succinct
  • Do not over exaggerate your achievements or claims as this can be a probity issue and lead to an application being marked down, deemed not appropriate or even reported to the GMC.

The maximum score possible in the CST application portfolio self-assessment in 2024 is 52.

Examples of things you could do to gain points include:

  • Demonstrate a strong logbook
  • Complete audits and quality improvement projects that lead to a demonstrable improvement in patient care/saftey
  • Present at local, regional, national and international conferences – poster or oral
  • Gain a teaching qualification
  • Organise or teach on a course/programme
  • Take on a leadership role such as becoming a BMA rep
  • Join the Royal College of Surgeons as an Affiliate
  • Publish your work as a first author or contribute to other’s work as non-first author. Publications can take months to materialise start planning for these very early on in your journey.

How should I prepare for the Multi-Specialty Recruitment Assessment (MSRA)

The MSRA is a computer-based assessment, delivered in partnership with Work Psychology Group and Pearson VUE, which has been designed to assess some of the essential competences outlined in the Person Specification and is based around clinical scenarios.

Only the top 1200 applicants at MSRA will be invited to interview. Information regarding the MRSA can be found in the MRSA applicants guide.

The MRSA also contributes to the applicant’s final score with the following contributions: MRSA score (10%) , along with the verified evidence score (30%) and overall interview score (60%).

What is the interview format for Core Surgical Training (CST) interviews in 2024?

If your application is successfully shortlisted, you’ll be invited for an interview. It’s crucial to schedule your interview on Oriel at your earliest convenience. The slots are allocated on a first-come, first-served basis, so prompt action is advised.

The interviews for the 2024 cycle will be conducted online. All interviews will be conducted online on Qpercom video platform between Monday 19th February to Wednesday 28th February 2024. Ensure you have a stable internet connection and a device equipped with a camera and microphone for the video interview. Test your setup beforehand to avoid any lighting issues, like backlighting from windows, which can be mitigated by closing blinds or curtains.

You can join using the link sent after you have booked a slot. You should join 5+ minutes before the scheduled time and will first have your identity confirmed by a member of admin staff. Make sure that you have photo ID to hand (your passport or UK driving licence) and that you are alone in the room you are interviewing from. as specified in your Oriel invitation.

The 2024 CST interview will last 20 minutes, with two sections covering management and clinical scenarios, each for 10 minutes. There is no break in-between.

You will have to deliver a pre-prepared 3-minute presentation. The topic will be given to you in advance. There will be 2 minutes of follow-up questions. The second half of the station will involve you answering a management scenario and tests your thinking on your feet. We have covered this in detail in the Management Section.

Clinical station

The clinical scenario stations aims to assess your clinical competencies using clinical scenarios to guide this. The scenario will likely be a surrounding a condition that you be expected to be able to manage as a day one core trainee and therefore should be relatively straightforward. 

There may be a possible ‘trap’ but this is to test your competency. This is likely to be in the form of ensuring you don’t miss certain very important red flags. Examples include:

  • Loin to groin pain – Abdominal aortic aneurysm 
  • Nurses call about leg swelling – Acute limb ischaemia
  • Cellulitis in an immunocompromised patient – Necrotising fasciitis
  • Sore throat – Acute airway obstruction

These may sound obvious but in the stress of an interview they are easily missed!

There will be 2 scenarios each lasting 5 minutes:

  • Both scenarios will be provided during the interview you will have to answer with no time for preparation. For this we suggest you take a few seconds to think. Many people will dive straight into this missing the whole point of the scenario and risk missing the important red flags discussed above. 

Scoring (each scenario will be scored separately)

  • Clinical skills & knowledge
  • Judgement under pressure & prioritisation
  • Communication

0 – No Evidence,  1 – Very Poor, 2 – Weak, 3 – Satisfactory,  4 – Good, 5 – Excellent, 6 – Outstanding

At MediGuru, we have developed a comprehensive, up to date, CST Interview Question Bank, that compiles everything you need to prepare for the interview in one place, accessible anytime, anywhere from a mobile phone, tablet or desktop. The example stations are fully worked with background knowledge and additional reading.

Our worked examples are grouped by specialty. Remember this is an interview for CORE surgical training. Whilst many of you will have decided what specialty you wish to pursue, the interview wants to pick safe, well rounded, able to cross-cover specialties 

An example of a clinical vignette from the MediGuru Core Surgical Training (CST) Interview Question Bank is below.

We are happy to be contacted if you feel additional scenarios need to be added. 

Management station

The management station aims to test how you would apply your management and leadership skills in daily practice and relates to clinically-related ethical and logistical issues.

This 10 minute station is split into two sections

  1. Pre-prepared presentation – 3 minutes for presentation, 2 minutes for questions and answers
  2. Management scenario – 5 minutes to answer the question. The questions are structured to encourage the applicant to think on their feet


  • Management involves controlling and directing available resources or people in a group to achieve objectives that have previously been established.
  • Leadership involves setting a direction or vision that others follow in order to achieve common goal.

In this station you will be given a scenario and will be asked to explain how you would approach and manage this situation. You may be asked an opening question, followed by a competence question and then an advanced question.

Interview Scoring Criteria


(0 – no evidence, 1 – very poor, 2 – weak, 3 – satisfactory, 4 – good, 5 – excellent, 6 – outstanding)

  • Content
  • Presentation Skills
  • Questioning

Management Questions

(0 – no evidence, 1 – very poor, 2 – weak, 3 – satisfactory, 4 – good, 5 – excellent, 6 – outstanding)

  • Probity & Professional integrity and awareness of safety & ethics
  • Judgement under pressure & prioritisation
  • Communication

Pre-Prepared Presentation

This part of the management station involves presenting a 3 minute pre-prepared presentation followed by 2 minutes of questions. The presentation title is usually emailed a fortnight in advance of the interview date. The topic may focus on any aspect of the person specification, however in previous years the topic has focused around ‘leadership’. e.g.

“Please tell us about your leadership biography, based on skills you have acquired as a leader, both inside and outside of medicine and how you will be able to apply these to core surgical training.” 

An an example of a management scenario from the MediGuru CST Interview Question Bank is below:

MediGuru’s top tips for the management station

  • As you only have three minutes, it is important to keep the presentation concise. Perhaps make 3 clear points and expand on this.
    Try and think of unique and interesting examples.
  • If the title asks for examples both inside and outside of medicine, remember to give at least two examples one within medicine and one outwith.
  • The question will often ask you to ‘apply your acquired skills to core surgical training’  – do not forget to answer this part of the station
  • Practice timing – you will be stopped if you overrun three minutes.
  • Practice with a colleague and record your presentation
  • Remember to be conscious about your own body language e.g. do not fidget

Top tips for securing a Core Surgical Training (CST) number in 2024

Here are the MediGuru top tips for securing a Core Surgical Training (CST) number:

  • Prepare Thoroughly: Familiarize yourself with common interview questions and scenarios specific to your field. Regular practice and mock interviews can significantly boost your confidence and performance.
  • Understand the Criteria: Know the scoring system and the competencies being assessed. Tailor your responses and examples to demonstrate these key skills and qualities.
  • Showcase Professionalism: Dress appropriately, maintain a calm demeanor, and be punctual. Your professional conduct is often as important as your answers.
  • Effective Communication: Practice clear and concise communication. Listen carefully to questions, and ensure your responses are well-structured and relevant.
  • Reflect and Improve: After each interview or practice session, reflect on your performance. Seek feedback and work on areas that need improvement to continuously enhance your skills.

How are the CST interviews scored?

As previously mentioned the MRSA score represents 10% of the overall score, the verified evidence score represents 30%, the interview score 60%. Performing well at interview represents your best chance of securing a core surgical training number!

Claiming interview expenses for theCore Surgical Training (CST) interview

You may be eligible to claim travel and accommodation expenses for attending the interview. Further information can be found on the Health Education England website.

Can I apply for a Core Surgical Training (CST) number as an International Medical Graduate (IMG)?

From 6 October 2019, all medical practitioners have been added to the Shortage Occupation List in the UK. This means that all medical practitioners are exempt from the Resident Labour Market Test (RLMT) and can apply for any specialty in any recruitment round, subject to eligibility.

In summary

Although the process might seem daunting and the competition ever more fierce, securing a Core Surgical Training is achievable with focused planning and preparation. At MediGuru, we want to help as many postgraduate doctors reach their full potential and get through the training bottle-necks with the minimum stress. Our Core Surgical Training (CST) comprehensive guide and interview question bank have been instrumental in assisting hundreds of doctors prepare fro this significant stage in their training. That’s why we set up this resource and continue to improve it everyday.

You may be thinking about applying to other specialities. Check out our Radiology ST1 interview question bank, and look out for new specialties being added soon. If you would like to work with us, please get in touch!

Key links and documents

Oriel Recruitment System

2024 CST Applicant Handbook

2024 Self-Assessment Scoring Guide

2024 Person Specification

MSRA Applicant Guide

HEE Candidate Expenses Policy

”MediGuru’s ENT resource was detailed and well organised. It really helped my prep for my interview and I couldn’t have done it without it. Highly recommend!”

– 4th ranked candidate
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